Deniz Ertan1, Caroline Hubert-Jacquot2, Louis Maillard3, Stéphane Sanchez4, Claire Jansen2, Léa Fracomme2, Raymund Schwan5, Lucie Hopes6, Hervé Javelot7, Louise Tyvaert3, Jean-Pierre Vignal8, Wissam El-Hage9, Coraline Hingray10. 1. Centre Médical de la Teppe, Tain-l'Hermitage, France; Université de Lorraine, CNRS, CRAN, UMR 7039, Nancy, France; CHRU de Nancy, Département de Neurologie, Nancy, France. 2. Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France; Université de Lorraine, Faculté de Médecine, Vandœuvre-lès-Nancy, France. 3. Université de Lorraine, CNRS, CRAN, UMR 7039, Nancy, France; CHRU de Nancy, Département de Neurologie, Nancy, France; Université de Lorraine, Faculté de Médecine, Vandœuvre-lès-Nancy, France. 4. Pôle Information médicale évaluation performance, CH de Troyes, Troyes, France. 5. Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France; Université de Lorraine, Faculté de Médecine, Vandœuvre-lès-Nancy, France; INSERM U1114, Université de Strasbourg, Strasbourg, France. 6. CHRU de Nancy, Département de Neurologie, Nancy, France. 7. Etablissement Public de Santé Alsace Nord, Brumath, France. 8. Université de Lorraine, CNRS, CRAN, UMR 7039, Nancy, France; CHRU de Nancy, Département de Neurologie, Nancy, France. 9. UMR 1253, iBrain, Université de Tours, INSERM, Tours, France; CHU de Tours, Tours, France. 10. Université de Lorraine, CNRS, CRAN, UMR 7039, Nancy, France; CHRU de Nancy, Département de Neurologie, Nancy, France; Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France. Electronic address: c.hingray@chru-nancy.fr.
Abstract
OBJECTIVE: Fear of having a seizure called anticipatory anxiety of epileptic seizure (AAS), constitutes a daily life burden but has been rarely studied. Our aim was to assess the prevalence and the determining factors of AAS in patients with drug-resistant focal epilepsy, a dimension that has not been thoroughly investigated before. METHODS: We conducted an observational, prospective study enrolling patients with drug-resistant focal epilepsy. The psychiatric assessment aimed to evaluate psychiatric comorbidities, trauma history, and quality of life using hetero-evaluation and self-assessment tools. Dimensions of anxiety specifically related to epilepsy (peri-and-inter-ictal) were explored as exhaustively as possible. RESULTS: AAS was found in 53 % of the 87 patients. We compared the two groups of patients: with or without AAS. Patients with AAS had a significantly shorter duration of epilepsy (p = 0.04). There was no difference between groups with respect to psychiatric disorders, except for cannabis dependence, more frequent in patients with AAS (p = 0.02). Compared to patients without AAS, those with AAS presented more subjective ictal anxiety (p = 0.0003) and postictal anxiety (p = 0.02), were more likely to avoid outdoor social situations due to seizure fear (p = 0.001), and had a poorer quality of life (QOLIE emotional well-being; p = 0.03). Additionally, they had experienced more traumatic events in their lifetime (p = 0.005) and reported more frequently a feeling of being unsafe during their seizures (p = 0.00002). SIGNIFICANCE: AAS is a specific dimension of anxiety, possibly linked to trauma history. AAS is strongly linked to subjective ictal anxiety but not to the objective severity of seizures or frequency.
OBJECTIVE: Fear of having a seizure called anticipatory anxiety of epileptic seizure (AAS), constitutes a daily life burden but has been rarely studied. Our aim was to assess the prevalence and the determining factors of AAS in patients with drug-resistant focal epilepsy, a dimension that has not been thoroughly investigated before. METHODS: We conducted an observational, prospective study enrolling patients with drug-resistant focal epilepsy. The psychiatric assessment aimed to evaluate psychiatric comorbidities, trauma history, and quality of life using hetero-evaluation and self-assessment tools. Dimensions of anxiety specifically related to epilepsy (peri-and-inter-ictal) were explored as exhaustively as possible. RESULTS:AAS was found in 53 % of the 87 patients. We compared the two groups of patients: with or without AAS. Patients with AAS had a significantly shorter duration of epilepsy (p = 0.04). There was no difference between groups with respect to psychiatric disorders, except for cannabis dependence, more frequent in patients with AAS (p = 0.02). Compared to patients without AAS, those with AAS presented more subjective ictal anxiety (p = 0.0003) and postictal anxiety (p = 0.02), were more likely to avoid outdoor social situations due to seizure fear (p = 0.001), and had a poorer quality of life (QOLIE emotional well-being; p = 0.03). Additionally, they had experienced more traumatic events in their lifetime (p = 0.005) and reported more frequently a feeling of being unsafe during their seizures (p = 0.00002). SIGNIFICANCE: AAS is a specific dimension of anxiety, possibly linked to trauma history. AAS is strongly linked to subjective ictal anxiety but not to the objective severity of seizures or frequency.